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      Interactions between antidepressants and antihypertensive and glucose lowering drugs among patients in the HIPERDIA Program, Coronel Fabriciano, Minas Gerais State, Brazil Translated title: Interações entre antidepressivos e medicamentos e anti-hipertensivos e hipo-glicemiantes em pacientes do Programa HIPERDIA em Coronel Fabriciano, Minas Gerais, Brasil

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          Abstract

          The aims of this study were to investigate the prevalence and to describe the most frequent potential interactions between antidepressants and antihypertensive and glucose lowering drugs in the HIPERDIA Program at two primary care units in Coronel Fabriciano, Minas Gerais State, Brazil. Data were collected through the patient registry in the HIPERDIA Program and the local psychoactive drug dispensing system. Interactions were classified as due to pharmacokinetic and/or pharmacodynamic mechanisms. Prevalence of antidepressant use in the HIPERDIA Program was 4.37% (29 of patient 663 records). Of the HIPERDIA patients in treatment with antidepressants, 19 were exposed to 47 interactions, 23.4% of which involving pharmacokinetic, 61.7% pharmacodynamic synergy, and 15.9% simultaneous pharmacokinetic and pharmacodynamic mechanisms. Complications can arise from drug-drug interactions, a situation that can escape the attention of prescribing health professionals.

          Translated abstract

          O objetivo do estudo foi investigar a prevalência e descrever as possíveis interações de medicamentos mais freqüentes entre antidepressivos e anti-hipertensivos/hipoglicemiantes do programa HIPERDIA de duas unidades básicas de saúde do Município de Coronel Fabriciano, Minas Gerais, Brasil. A coleta de dados foi realizada mediante consulta ao caderno de cadastro dos pacientes usuários do programa de HIPERDIA e pela consulta ao sistema de dispensação de psicotrópicos do município. As interações foram classificadas segundo o mecanismo farmacocinético e farmacodinâmico. A prevalência do uso de antidepressivos em pacientes do HIPERDIA foi de 4,37% (29 de 663 cadastros analisados). Dos pacientes do HIPERDIA em tratamento com antidepressivos, 19 estão expostos a 47 interações, 23,4% delas ocorrem por mecanismos farmacocinéticos, 61,7% por mecanismos farmacodinâmicos de sinergismo e 15,9% interagem das duas formas simultaneamente. Complicações podem ser provocadas por interações entre fármacos e os profissionais prescritores podem não estar atentos a tal fato.

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          Most cited references15

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          Inappropriate medication use in community-residing older persons.

          Elderly patients taking inappropriate drugs are at increased risk for adverse outcomes. We investigated the prevalence of inappropriate drug use and its predisposing factors in community-residing older persons. We conducted in-home interviews with 414 subjects aged 75 years and older living in the community of Santa Monica, Calif. Inappropriate medication use was evaluated using explicit criteria developed through a modified Delphi consensus process. These criteria identified drugs that should generally be avoided in elderly community-residing subjects regardless of dosage, duration of therapy, or clinical circumstances. Based on these conservative criteria, 14.0% of the subjects were using at least one inappropriate drug. The most common examples were long-acting benzodiazepines, persantine, amitriptyline, and chlorpropamide. Subjects using three or more prescription drugs, compared with one or two, were more likely to be taking an inappropriate medication (odds ratio, 3.9; 95% confidence interval, 1.9 to 7.9). Furthermore, subjects with depressive symptoms had a higher risk of receiving inappropriate medications than nondepressive subjects (odds ratio, 2.2; 95% confidence interval, 1.1 to 4.1). Inappropriate drug use is a common problem in community-residing older persons. The risk of inappropriate drug use is increased in patients taking multiple medications and in patients with depressive symptoms.
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            Portaria nº 344, de 12 de maio de 1998. Aprova o Regulamento Técnico sobre substâncias e medicamentos sujeitos a controle especial.

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              Drug combinations and potential for risk of adverse drug reaction among community-dwelling elderly.

              Data were gathered through personal interviews from a sample of 667 people 65 years of age and older, living in community settings and managing their own health. Almost two thirds of these older respondents reported at least one drug-drug or drug-alcohol combination associated with a possible adverse reaction. The largest percentage of respondents were taking combinations of medications that could place them at risk for hypotension and cognitive impairment. These results suggest the need for more detailed screening of specific medications used by older people who report taking certain categories of drugs.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                csp
                Cadernos de Saúde Pública
                Cad. Saúde Pública
                Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz (Rio de Janeiro, RJ, Brazil )
                0102-311X
                1678-4464
                October 2009
                : 25
                : 10
                : 2229-2236
                Affiliations
                [01] Coronel Fabriciano orgnameCentro Universitário do Leste de Minas Gerais orgdiv1Curso de Farmácia Brasil
                Article
                S0102-311X2009001000013
                10.1590/S0102-311X2009001000013
                1646f1ee-7808-427d-80b1-891db1b7320e

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 07 July 2008
                : 10 March 2008
                : 01 October 2008
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 22, Pages: 8
                Product

                SciELO Brazil

                Categories
                Article

                Anti-Hipertensivos,Antidepressivos,Drug Interactions,Antihypertensive Agents,Hypoglycemic Agents,Antidepressive Agents,Interações de Medicamentos,Hipoglicêmicos

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